=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598129934
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VN DURABLE MEDICAL EQUIPMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2016
-----------------------------------------------------
Last Update Date | 04/12/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12555 GARDEN GROVE BLVD STE 306
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92843-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-260-8918
-----------------------------------------------------
Fax | 714-537-7776
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12555 GARDEN GROVE BLVD STE 306
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92843-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-260-8918
-----------------------------------------------------
Fax | 714-537-7776
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO, OWNER
-----------------------------------------------------
Name | MR. JOHN DINH
-----------------------------------------------------
Credential | RCP, RRT
-----------------------------------------------------
Telephone | 714-260-8918
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 77658
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------